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issues in oncology

ASCO and Friends of Cancer Research Launch Initiative to Modernize Eligibility Criteria for Clinical Trials

The dismal accrual rates in cancer clinical trials are well known: Just 3% to 5% of adults with cancer enroll in clinical trials.1 The reasons patients are reluctant to participate in clinical trials are equally well known: fear of reduced quality of life, concern about receiving a placebo, and...

cost of care

ASCO Plenary Studies: Assessing the ‘Value’ of New Treatments

At the 2016 ASCO Annual Meeting, studies presented at the Plenary Session gave attendees new treatment strategies to employ back home. But in the emerging push to contain the cost of new cancer treatments, do the four interventions fit within the new “value framework” for oncology? Deborah Schrag, ...

survivorship
pain management

ASCO Releases Clinical Practice Guideline on Management of Chronic Pain in Survivors of Adult Cancers

As reported in the Journal of Clinical Oncology by Judith A. Paice, PhD, RN, of Northwestern University, and colleagues, ASCO has released a clinical practice guideline on management of chronic pain in survivors of adult cancers. The guideline was based on literature review by an expert panel, with ...

breast cancer

Insurance, Distance to Care Can Be Barriers to Breast Reconstruction

Women were less likely to have breast reconstruction surgery after mastectomy if they had Medicaid or Medicare rather than private insurance or if they lived 10 or more miles from a plastic surgeon’s office, a University of North Carolina (UNC) Lineberger Comprehensive Cancer Center study has ...

breast cancer

Sampling Method Used for New Breast Cancer Tests May Lead to Underestimation of Risk

Not only is breast cancer more than one disease, but a single breast cancer tumor can vary within itself, a finding that University of Pittsburgh Cancer Institute (UPCI) researchers discovered has the potential to lead to very different patient treatment plans depending on the tumor sample and...

prostate cancer

Sociodemographic and Clinical Predictors of Switching to Active Treatment From Observational Management in Low-Risk Prostate Cancer

Although active surveillance for patients with low-risk prostate cancer has become an increasingly acceptable strategy for disease management, many men opt for definitive therapies such as radical prostatectomy or radiation therapy. A new study of more than 2,200 patients with low-risk prostate...

colorectal cancer

No Improvement in Outcome Reported With Longer Wait Between Radiochemotherapy and Surgery in Rectal Cancer

Pathologic complete response rate was not improved by increasing the interval between neoadjuvant chemoradiotherapy and surgery from 7 to 11 weeks in patients with rectal cancer, according to the French phase III GRECCAR-6 trial reported by Lefevre et al in the Journal of Clinical Oncology. In...

gynecologic cancers

Potential Increased Risk of Serous/Serous-like Endometrial Carcinoma After RRSO in Women With BRCA1 Mutation

In a prospective cohort study reported in JAMA Oncology, Shu et al found that risk for serous/serous-like endometrial carcinoma appeared to be increased after risk-reducing salpingo-oophorectomy (RRSO) without hysterectomy in women harboring the BRCA1 mutation. The overall risk of uterine cancer...

leukemia

Study Evaluates Chronic Graft-vs-Host Disease Burden and Complications in Patients Receiving Bone Marrow Transplants

A University of Colorado Cancer Center study compared outcomes of leukemia patients receiving bone marrow transplants from 2009 to 2014, finding that 3 years post transplant, the incidence of severe chronic graft-vs-host disease was significantly higher in patients who had received transplants from ...

cns cancers

Effect of Radiosurgery Alone vs Radiosurgery Plus WBRT on Cognitive Function in Patients With Brain Metastases

Physicians from Carolinas HealthCare System's Neurosciences Institute and Levine Cancer Institute are among the authors of a study published by Brown et al in JAMA. The study showed how among patients with one to three brain metastases, the use of stereotactic radiosurgery (SRS) alone, compared...

skin cancer

Pathway Defects in Acquired Resistance to PD-1 Inhibition in Melanoma Identified

In a study reported in The New England Journal of Medicine, Zaretsky et al found that defects in interferon receptor signaling and antigen-presenting pathways were associated with acquired resistance to PD-1 (programmed cell death protein 1) inhibition in melanoma. Resistance Mutations Identified ...

issues in oncology

Delirium Frequent and Underdiagnosed Among Advanced Cancer Patients Presenting to an Emergency Department

A new study indicates that delirium is relatively frequent and underdiagnosed by physicians in patients with advanced cancer visiting the emergency department. Delirium was similarly common among older and younger patients, which suggests that in the setting of advanced cancer, all patients should...

lymphoma

Is Nivolumab Active in Classical Hodgkin Lymphoma After Failure of Autologous SCT and Brentuximab Vedotin?

Treatment with the anti–PD-1 (programmed cell death protein 1) immune checkpoint inhibitor nivolumab (Opdivo) produced response in two-thirds of patients with classical Hodgkin lymphoma after failure of both autologous stem cell transplantation (SCT) and brentuximab vedotin (Adcetris),...

multiple myeloma

FDA Grants Breakthrough Therapy Designation for Daratumumab in Combination With Standard of Care for Multiple Myeloma

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy Designation to the immunotherapy daratumumab (Darzalex) in combination with lenalidomide (Revlimid) and dexamethasone, or bortezomib (Velcade) and dexamethasone, for the treatment of patients with multiple myeloma who have ...

prostate cancer

Patients With Low-Risk Prostate Cancer on Active Surveillance Experience Good Quality of Life

Active surveillance has become an increasingly important alternative to surgery, chemotherapy, or radiation treatment for men diagnosed with low-risk prostate cancer. However, what is the impact of active surveillance on health-related quality of life in patients selected or opting for this...

supportive care
symptom management

Olanzapine Combination Reduces Nausea and Vomiting in Patients Receiving Highly Emetogenic Chemotherapy

In a phase III trial reported by Navari et al in The New England Journal of Medicine, the addition of the antipsychotic agent olanzapine vs placebo to dexamethasone, aprepitant, or fosaprepitant, and a 5-hydroxytryptamine type 3–receptor antagonist reduced nausea and improved antiemetic...

issues in oncology

Some Adolescent Survivors of Childhood Cancer May Benefit From More Comprehensive Mental Health Screening

Most adolescent survivors of childhood cancer have no reported psychological symptoms, but an analysis led by St. Jude Children's Research Hospital found that those who do often have multiple symptoms and distinct symptom profiles. The findings, published by Krull et al in the Journal of Clinical...

survivorship
leukemia
lymphoma

My Commitment to Helping Other Survivors of Childhood Cancers

When I was diagnosed with acute lymphocytic leukemia (ALL) at the age of 2 in 1974, not much was known about the cancer or the side effects of its treatment. Too young to understand what was happening to me, the burden fell to my parents and older sibling to protect and care for me. For more than...

hematologic malignancies

Ipilimumab Appears Active in Relapsed Hematologic Cancer After Allogeneic HSCT

In a phase I/Ib study reported in The New England Journal of Medicine, Davids et al found that ipilimumab (Yervoy; at a dose of 10 mg/kg) produced responses, including complete responses, in patients with relapsed hematologic cancer after allogeneic hematopoietic stem cell transplantation (HSCT)....

breast cancer

In Vitro Fertilization Not Associated With Increased Risk of Breast Cancer in Dutch Study

Among women undergoing fertility treatment in the Netherlands between 1980 and 1995, the use of in vitro fertilization (IVF) compared with non-IVF treatment was not associated with increased risk of breast cancer after a median follow-up of 21 years, according to a study published by van den...

leukemia

Clinical Trials Actively Recruiting Patients With Acute Myeloid Leukemia

Phase I/II Study Title: A Phase I-II Randomized Trial of a Combination of ­Nintedanib/Placebo in Combination With Induction Chemotherapy for Patients With Refractory or First-Relapse AML Study Type: Phase I/II/interventional/parallel assignment Study Sponsor and Collaborators: Yale University,...

issues in oncology

Study Finds Poor Understanding of Illness in Patients With Advanced Cancer

Few patients with advanced cancer and a short life expectancy have an accurate understanding of their illness, according to a study reported in the Journal of Clinical Oncology by Andrew S. Epstein, MD, of the Memorial Sloan Kettering Cancer Center, New York, and colleagues. The study involved 178...

breast cancer

Mindfulness-Based Stress-Reduction Program May Reduce Psychological and Physical Symptoms in Breast Cancer Survivors

A mindfulness-based stress-reduction program for breast cancer survivors was associated with psychological and physical symptom benefits during and at 6 weeks after intervention, according to a randomized trial reported in the Journal of Clinical Oncology by Cecile A. Lengacher, RN, PhD, of the...

University of Kansas School of Medicine Names Allen M. Chen, MD, Department of Radiation Oncology Chair

Allen M. Chen, MD, has been appointed the new Joe and Jean Brandmeyer Chair of the Department of Radiation Oncology at the University of Kansas School of Medicine. He will join the faculty on October 1, 2016. Dr. Chen will succeed Terry Tsue, MD, the Douglas A. Girod, MD, Endowed Professor of Head ...

Rajesh K. Garg, MD, JD, Named President, CEO of CTCA

Rajesh K. Garg, MD, JD, is now President and CEO of Cancer Treatment Centers of America Global, Inc (CTCA). The announcement was made by CTCA earlier this spring. Dr. Garg, who started this new position on June 20, 2016, will also serve as a member of the company’s national Board of Directors. Dr. ...

The Healing Power of Words

Feminist literary scholar Susan Gubar was diagnosed with advanced ovarian cancer in November 2008. She then began her emigration “from the world of the healthy to the domain of the ill,” she wrote in her acclaimed book, Memoir of a Debulked Woman: Enduring Ovarian Cancer. In her memoir, she...

An Epic Medical Story by an Old-Style Doctor on the Front Lines of Care

The U.S. health-care system is a $3 trillion behemoth of dizzying complexity. Government oversight, ever-changing regulations, mountains of paperwork, electronic health records, initiative after initiative, and so forth, all of which has reshaped the delivery of care, for the good and bad. But...

FDA Advances Precision Medicine Initiative by Issuing Draft Guidances on Next-Generation Sequencing–Based Tests

In support of the President’s Precision Medicine Initiative, on July 6, the U.S. Food and Drug Administration (FDA) issued two draft guidances. When finalized, they will provide a flexible and streamlined approach to the oversight of tests that detect medically important differences in a person’s...

Fentanyl Nasal Spray Now Available at a Dose of 300 µg for Treatment of Breakthrough Cancer Pain

Fentanyl (Lazanda) nasal spray, a schedule II narcotic, is now available at a 300-µg dose to treat breakthrough cancer pain, offering physicians another titration option for dosing flexibility. The new strength can help physicians more easily and accurately target the appropriate dose for patients, ...

colorectal cancer

New ASTRO Clinical Practice Statement Updates Treatment Standard for Rectal Cancer

The American Society for Radiation Oncology (ASTRO) recently issued a new clinical practice statement, “Appropriate Customization of Radiation Therapy for Stage II and III Rectal Cancer: An ASTRO Clinical Practice Statement Using the RAND/UCLA Appropriateness Method.” An executive...

issues in oncology

As Low-Dose CT Screening Moves Into the Clinic, Implementation Issues Move Up on the Agenda

Low-dose computed tomography (CT) screening for lung cancer in high-risk groups is moving into the clinic in the wake of its approval by the U.S. Centers for Medicaid & Medicare Services. That does not mean, however, the discussion is over. As low-dose CT moves from research to everyday...

lung cancer

Lung Cancer Screening: Beneficial for Certain Populations but Not Without Controversy

The National Cancer Policy Forum of the National Academies of Sciences took up the issue of lung cancer screening at its mid-June workshop. Greta Massetti, PhD, Associate Director for Science, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC), and chair of ...

pancreatic cancer

ASCO Guideline on Metastatic Pancreatic Cancer

As reported in the Journal of Clinical Oncology by Davendra P.S. Sohal, MD, MPH, of Cleveland Clinic, and colleagues, ASCO has released a clinical practice guideline on the treatment of patients with metastatic pancreatic cancer.1 Recommendations are based on an expert panel systematic review of...

pancreatic cancer

ASCO Guideline on Treatment of Locally Advanced, Unresectable Pancreatic Cancer

As reported by Edward P. Balaban, DO, FASCO, of Penn State Hershey Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on the treatment of locally advanced, unresectable pancreatic cancer.1 The recommendations are based on expert...

pancreatic cancer

ASCO 2016 Guidelines for the Treatment of Pancreatic Cancer: Why Another Guideline?

The 5-year survival rate of those diagnosed with pancreatic cancer remains stubbornly fixed around 5%. Even in the 20% of cases in which surgical resection is undertaken for curative intent, the 5-year survival rate after surgery is 20% to 30%. As we make progress in other cancers with decreasing...

gynecologic cancers

Pap Smear Screenings May Help Prevent Cervical Cancer in Women Over 65

A new study from the University of Illinois confirms a link between Papanicolaou (Pap) smear screenings and a lower risk of developing cervical cancer in women over age 65. However, most American health guidelines discourage women in that age range from receiving screenings unless they have...

pancreatic cancer

ASCO Guideline on Potentially Curable Pancreatic Cancer

As reported in the Journal of Clinical Oncology by Alok A. Khorana, MD, of Cleveland Clinic, and colleagues, ASCO has released a clinical practice guideline on the treatment of potentially curable pancreatic cancer.1 The recommendations are based on an expert panel systematic review of the...

breast cancer

ASCO Guideline on Endocrine Therapy for Metastatic Breast Cancer: Reaffirming Principles for Making Treatment Decisions

The role of endocrine therapy for hormone receptor–positive metastatic breast cancer is well established, and clinicians are strongly encouraged to consider one of several therapeutic options for the majority of patients who present with metastatic disease. The recent ASCO guideline on this topic, ...

breast cancer

ASCO Guideline on Endocrine Therapy for Hormone Receptor–Positive Metastatic Breast Cancer

As reported by Hope S. Rugo, MD, of the University of California San Francisco Comprehensive Cancer Center, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on endocrine therapy for hormone receptor–positive metastatic breast cancer.1 The...

issues in oncology

Discovery of Fragment Length of Circulating Tumor DNA Might Increase Liquid Biopsy Sensitivity

The liquid biopsy may be a welcome reprieve from typical biopsies. The minimally invasive test could reduce the need for the sometimes painful and risky procedures involved in sampling tumors, particularly those that reside deep within the body. However, thus far, the utility of the test has been...

lymphoma

Five-Year Survival Data: Brentuximab Vedotin May Be Curative in Some Patients With Hodgkin Lymphoma

Five-year survival data published by Chen et al in Blood suggest that the targeted therapy brentuximab vedotin (Adcetris) may be curative in some patients with Hodgkin lymphoma whose disease has persisted despite receiving previous therapies. This multinational phase II study examined brentuximab...

survivorship

Endocrine Abnormalities Increase Over Time in Aging Survivors of Childhood Cancer

The cumulative incidence of endocrinopathies steadily increased over time in aging survivors of childhood cancers, according to an analysis of data from the Childhood Cancer Survivor Study reported by Mostoufi-Moab et al in the Journal of Clinical Oncology. Study Details The study included...

issues in oncology
health-care policy

Road to Successful Use of Real-World Evidence for Drug Development Is Long and Rocky

Friends of Cancer Research (Friends) has been a leader in the push for better and faster cancer drug development. Now it is tackling the use of real-world evidence in clinical trials. This is the report of a meeting on the subject that took place on June 16 in Washington, DC.1 Real-world evidence...

breast cancer
solid tumors

Study Finds Wide Variation in Breast Density Assessments Among Radiologists

A large observational study examining the variation in breast density assessment among radiologists in clinical practice has found a wide variation—from 6.3% to 84.5%—in the percentage of mammograms rated as showing dense breasts, which persisted after adjusting for patient...

breast cancer

The Metastatic Breast Cancer Project: Direct-to-Patient Research Initiative

A nationwide project is enlisting patients with breast cancer to share their tumor samples and clinical information. Launched in October 2015, the Metastatic Breast Cancer (MBC) Project has enrolled more than 2,000 patients from all 50 states and is yielding information that will be shared with...

breast cancer
issues in oncology
genomics/genetics

Using Social Media to Accelerate Genomic Research

The success of using social media to push forward causes for social good was a driving factor in the launch this past October of the Metastatic Breast Cancer Project (MBC project), which aims to accelerate the understanding of what makes patients with metastatic breast cancer genetically unique....

Sarah S. Donaldson, MD, FASCO, Honored With Inaugural Women Who Conquer Cancer Mentorship Award

Sarah S. Donaldson, MD, FASCO, of Stanford University School of Medicine and Lucile Packard Children’s Hospital, is the recipient of the Inaugural Women Who Conquer Cancer Mentorship Award. Throughout her decades-long career, Dr. Donaldson has mentored countless trainees and young oncologists,...

breast cancer

Quick Takes on Promising New Approaches to Treating Breast Cancer

At the 2016 ASCO Annual Meeting, researchers reported encouraging results for several new drugs and treatment strategies for breast cancer. The ASCO Post brings you brief summaries of a select few. Abemaciclib Trial The cyclin-dependent kinase 4/6 (CDK4/6) inhibitor abemaciclib produced responses...

HHS Announces Physician Groups Selected for Initiative Promoting Better Cancer Care

The U.S. Department of Health and Human Services (HHS) has announced that it has selected nearly 200 physician group practices and 17 health insurance companies to participate in a care delivery model that supports and encourages higher quality and more coordinated cancer care. The Medicare arm of...

Brachytherapy Pioneer Haakon Ragde, MD, Chosen as ASTRO 2016 Honorary Member

The American Society for Radiation Oncology (ASTRO) has selected Haakon Ragde, MD, as its 2016 Honorary Member, the highest honor ASTRO confers on distinguished cancer researchers, scientists, and leaders in disciplines other than radiation oncology, radiobiology, or radiation physics. Dr. Ragde...

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